The impact of admission plasma glucose on long-term mortality after STEMI and NSTEMI myocardial infarction

Diabetes mellitus is a widely recognized risk factor for cardiovascular disease. Type 2 diabetics have a 3-fold increased risk of CAD; prediabetics, without chronic hyperglycemia, have a 2-fold increased risk compared with normal subjects. We determined in 615 consecutive acute infarction patients whether the admission plasma glucose level remains associated with major adverse cardiovascular events (MACE) in an unselected patient population with myocardial infarction. Of these, the mean age of 66 +/- 12 years (range 36-90) and 69% were men and mean APG and HbA1c level were 8.2 +/- 4.0 mmol/l and 6.1 +/- 1.1% respectively. 13.2% of total study population was already known with diabetes. We recorded 132 deaths (21.5%), of whom 23.6% were known diabetic patients during 2.5 years of follow-up. Multivariate statistical analysis identified APG, older age and previous MI as independent mortality predictors. Conclusion: Increased APG levels are significantly and independently correlated with poor prognosis after myocardial infarction, and this underlines the need for better medical treatment of hyperglycemic state and aggressive screening for early detection of diabetes. (C) 2006 Elsevier Ireland Ltd. All rights reserved.